Perspectives of infectious disease specialists on shared decision-making for fever of unknown origin: a national survey in China.

Children's fractures and sports-related injuries represent a significant proportion of emergency department presentations worldwide, posing unique epidemiological and clinical management challenges (, ). Epidemiological data reveal that pediatric fractures commonly involve the upper and lower extremities, with distinct patterns influenced by age, sex, and activity type (). For instance, hand fractures constitute the second most frequent fracture type in children, with a predominance in males and a peak incidence in school-aged children and adolescents (–). The proximal phalanges are most commonly affected, and injury mechanisms vary with age, ranging from entrapment injuries in younger children to ball sports in older children (). Similarly, distal radius fractures are prevalent, accounting for over a quarter of pediatric fractures, with a male predominance and a higher incidence during spring months, often resulting from high-energy falls or sports participation (, ). Physeal fractures tend to occur in older children, while torus and bicortical fractures are more common in younger age groups (). Lower extremity fractures, including tibial and femoral fractures, also contribute substantially to pediatric trauma, with sports activities and falls being leading causes (–). Notably, tibial shaft fractures have been linked to board sports in certain regions, and femoral fractures show seasonal variation and are often associated with road traffic accidents and sports injuries depending on age (, ). The epidemiology of spinal fractures in children has evolved, with a noted decrease in road traffic incidents and an increase in sports-related injuries, predominantly affecting the thoracic and lumbar spine, and with a relatively low incidence of neurological deficits (, ). Facial fractures in children, although less frequently than in adults, demonstrate a male predominance and are often sports-related, with variations in fracture types and associated injuries influenced by age and sex (). The coronavirus disease 2019 (COVID-19) pandemic has further influenced pediatric trauma epidemiology, with reports indicating an overall decrease in fracture incidence but an increase in certain injury types such as high-acuity assaults and physical abuse, underscoring the complex interplay between societal factors and injury patterns (–). Together, these epidemiological insights support the need for tailored clinical approaches that consider injury mechanisms, anatomical characteristics, developmental stages, and recovery-related needs in children.